Provider Demographics
NPI:1215073978
Name:ROGERS, RONALD JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAMES
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14420 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-9329
Mailing Address - Country:US
Mailing Address - Phone:330-482-3778
Mailing Address - Fax:330-482-3778
Practice Address - Street 1:14420 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-9329
Practice Address - Country:US
Practice Address - Phone:330-482-3778
Practice Address - Fax:330-482-3778
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000118280OtherANTHEM
OH0509837Medicaid
OH350037691OtherRAILROAD MEDICARE
OH0509837Medicaid